Serial Thoracenteses in Parapneumonic Effusions

To the Editor: The recent medical literature has advocated the determination of pleural-fliuid chemistry to distinguish between uncomplicated parapneumonic effusions and effusions requiring thoracostomy-tube drainage.^{1 , 2} Light et al.² recently reported their experience with effusions accompanying pneumonia and stated that a chest tube should be employed if pleural fluid has any of the following: a grossly purulent appearance, organisms apparent on Gram stain, a glucose level below 40 mg per deciliter, or a pH below 7.0. If the pleural pH is above 7.2 or the lactic dehydrogenase is below 1000 IU per liter, the authors state that both tube thoracostomy and.  . .